The goal of this mid-career K24 application is to support the mentoring and research activities of Dr. Michael Fleming. He is committed to continuing an active research program in clinical and translational research. This grant is a competitive renewal that was initially funded in September 2005 and will end in September 2010. He is asking for an additional 5 years of funding. Dr. Fleming successfully completed the two research studies proposed in the initial application, participated in training activities and mentored PhD students, post doctoral fellows and faculty. During the period of the award he was elected to the National Academy of Sciences Institute of Medicine for his alcohol research and mentoring. He is also a national leader among the CTSA (Clinical Translational Science Award) programs and is the chair elect of the national CTSA Education Key Function Committee and Mentor Working Group. Work completed with current K24 grant: The first study evaluated two alcohol biomarkers, Blood Alcohol Levels and Carbohydrate-Deficient Transferrin (CDT), in a sample 214 patients admitted for trauma. The second study tested the efficacy of methylphenidate in a sample 13 children with a diagnosis of Attention Deficit Disorder and Fetal Alcohol Spectrum Disorder. Since 2005 his research group and trainees have published 42 research papers in the substance abuse area. Co-authors of these papers include five students, nine physician post doctoral research fellows, 11 University of Wisconsin-Madison physician faculty and scientists from 12 non-UW research groups. Over the last four years six of his trainees have been awarded K23/K08/K12/K01/R21/R03 grants, one MD PhD student was awarded an F30 and another PhD student an F31 grant. Without the salary and research support provided by the K24 grant much of this work and the success of his trainees would not have been possible. Proposed work for the K24 renewal: The K24 renewal will provide protected time for Dr. Fleming to mentor seven assistant professors in the departments of medicine, pediatrics and family medicine and facilitate his ability to write papers with trainees from three recently completed R01's. He will also initiate a prospective alcohol biomarker study that will test the predictive validity and reliability of Phosphatidylethanol (PEth) and CDT in a sample of 250 post liver transplant patients. Subjects will be recruited from four transplant centers. The biomarkers will be compared to patient self-report, family member interview and transplant staff concerns as well as medical records data. PEth and CDT will be measured at six-month intervals for one year. Significance: The K24 is critical for Dr. Fleming's continued ability to mentor new investigators in alcohol research and for his research on alcohol biomarkers. PUBLIC HEALTH RELEVANCE: The goal of the study is to find out if a lab test can tell which patients are drinking alcohol after having a liver transplant. A positive study would help physicians identify and treat patients before they damage their new liver.